Public Health Emergency - Leading a Nation Prepared
Chapter 4: Jurisdiction Incident Management (Tier 3)
Jurisdiction incident management (Tier 3) is the primary site of integration of healthcare organizations (HCOs) with fire/EMS, law enforcement, emergency management, public health, public works, and other traditional response agencies. It provides the structure and support necessary for medical assets to maximize MSCC, and it allows direct input by medical representatives into jurisdictional action planning and decision-making. In addition, it links local medical assets with State and Federal support.
Jurisdiction incident management (Tier 3) addresses MSCC at the level of the responding community. Earlier chapters focused on the management of individual healthcare assets (Tier 1) and on promoting cooperation among point-of-service medical providers (Tier 2). Tier 3 builds on this by describing the integration of public health and medical assets into the functional organization of incident command within the traditional emergency response community.
When a mass casualty and/or mass effect event occurs, multiple disciplines may be called into action, including public safety, public health, human services, emergency management, and others. Many of these disciplines do not routinely work together in this capacity and so are often unfamiliar with each other's emergency preparedness and response procedures. It is crucial, therefore, to establish incident management processes for jurisdictional (Tier 3) response that integrate the many diverse disciplines and promote coordinated response actions. This is accomplished through a well-organized and tested jurisdiction Emergency Operations Plan (EOP).
The basis for effective jurisdictional incident management (Tier 3) is the jurisdiction's Emergency Management Program (EMP). Public health and acute-care medical assets should be viewed as key components of the jurisdiction's EMP and should have direct input into preparedness and response planning. In times of crisis, jurisdictional management (Tier 3) will benefit from receiving a health and medical perspective on issues that determine incident objectives and response strategies. Moreover, individual HCOs may maximize their ability to provide MSCC through enhanced coordination with EMS and other community resources.
The integration of diverse organizations during incident response is best accomplished through unified incident command, a concept that allows multiple agencies to maintain significant management responsibility and to work together to achieve optimal response. A unified command approach promotes consistency throughout the response system. The participation of public health and medical disciplines in unified command at Tier 3 is important since they bear a primary responsibility for the welfare of responders and the general public.
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